Interview with Peterson Wachira on challenges facing implementation of Social Health Authority

By Peter Ochieng

The Kenya Union of Clinical Officers (KUCO) Chairman Peterson Wachira was in Kisumu on Monday, where he addressed journalists on various issues, including challenges bedeviling implementation of the Social Health Insurance.

Here are the excerpts:

NR: Bring us up to speed with an agreement recently signed between the Council of Governors and the Ministry of Health on empanelment of clinical officers in the SHA system?   

PW: You remember that on 14th of January, there was an agreement that was signed at the Council of Governors. That agreement was directing the social health authority through the Ministry of Health to ensure that they bring to an end the discrimination and the exclusion of clinic officers from social health authority.

To put it in simple terms, there was a directive between the governors and the Ministry of Health to the social health authority to enable clinic officers, whether working in private facilities or working on their own behalf as practitioners, to be enabled within the system of the social health authority so that they can see Kenyans through social health authority.

Three weeks after, we are here to say that that directive is yet to be effected. There is no clinical officer with a private facility who has been able to access the E-contracting platform though empanelment.

No clinic officer can be able to access E-contracting because still they only recognize one body, which is Kenya Medical Practitioners and Dentists Council (KMPDC). The second thing is that the pre-authorization is not yet happening.

NR: Is SHA working?

PW: Actually, it's not that SHA is not working. The issue is that the clinician who is supposed to see patients has not been enabled to see them through the SHA. And I'm happy that Parliament has seen the light.

I saw the other day, the leader of majority Kimani Ichung’wah saying that actually SHA has failed. And I think we have been shouting our throats hoarse for the past three months. It is good that now Parliament appreciates this.

We would like to tell them that the problem with the social health authority is the Secretariat, the management of the social health authority and not the law. It is the management, and that is why we continue to call for the disbandment of the management of social health authority. 

We have many Kenyans who are intelligent enough and who have goodwill and who understand that the social health authority is supposed to facilitate the achievement of universal health coverage.

NR: Is a strike in the offing?

PW: You remember that we suspended our strike for three weeks. We are saying that if they are not going to have enabled clinical officers to register their private facilities by the end of this week, we will be giving directions on the resumption of the strike action.

The second thing that we are doing is that we are already collecting signatures, and we will be petitioning Parliament to censure the management of the social health authority, together with the leadership, because they have proven that they are unable to perform their duties.

The social health authority was supposed to ensure access to every Kenyan wherever they are. It was also supposed to ensure that Kenyans are protected from financial hardships, but Kenyans are being subjected to use out of the pocket payment simply because a few greedy, selfish individuals want to capitalize on the issues of prioritization and registration of facilities.

This is a contravention of Article 43, 24 and 27 of the constitution. And we believe that it is enough reason to have some of the senior officers within the Ministry and social authority censured. And we shall be publicly submitting this petition either at the end of the week or next week.

NR: Your parting shot?

PW: We have also been calling upon the government, being the executive and the legislature, to improve our budget for healthcare towards the 15% that was agreed under the Abuja declaration.

Now I think every Kenyan can see the consequences, because as of the first of February, clinical officers that were employed in the TB and HIV clinics from the programs funded by the US are no longer at work after the programs were stopped.

Most of them have actually been given termination letters, and we are in a very big crisis. We actually do not have the clinical officers, nor do we have the drugs, because when the stock that we have gets finished, I don't think we even have a budget for us to be able to restock the HIV and TB medications.

I think this is a wakeup call to the government that number one, they must be able to absorb all the clinical officers who had been hired under these programs, because we already have a shortage.

We must absorb them into the mainstream civil service so that they can continue seeing our patients. But also, we must be able to increase the budget for health so that we can afford the TB and the HIV medications and even the vaccines that the donors were helping us.

So, my call to the National Assembly, because we are heading to the budget season, is that we must be able to incorporate these programs being the utilities and the human resource attached to ensure that these human resources are absorbed.